According to the American Diabetes Association, gestational diabetes, or diabetes acquired during pregnancy affects 4 percent of all pregnant women. Gestational diabetes can cause a woman to have a very large baby who may have very low blood sugars at birth. This can be dangerous for both the mother and the baby. Women who develop high blood pressure after 20 weeks of pregnancy have pregnancy induced hypertension. High blood pressure can decrease blood flow to the placenta and cause preterm birth, according to MayoClinic.com. Both of these conditions require special care and medications for treatment.
Medications for High Blood Pressure
It may be necessary for women to take blood pressure medications during their pregnancy. Most medications used for high blood pressure are thought to be safe for mother and baby. Aldomet or methyldopa is considered to be the first line therapy for pregnancy induced hypertension. According to a study reported in the July 2001 "American Family Physician," aldomet has the longest track record in treating pregnancy induced hypertension. Aldomet can cause hemolytic anemia which is the break down of red blood cells in both the mother and the baby. Labetalol is also widely used to treat pregnancy induced hypertension. Labetolol shoud not be used in patients with asthma or heart block. It should be used with caution during lactation.
ARBS and ACE Inhibitors
According to the American Heart Association, ACE inhibitors should be avoided because they can cause birth defects or kidney failure in the baby. Medications such as Lisinopril, Captopril and Altace are examples of ACE inhibitors. These medications are particularly dangerous in the second and third trimester and can result in injury or even death of the fetus, according to the "PDR Nurses Drug Handbook." Another group of blood pressure medications that can potentially cause kidney failure and death in the fetus is ARBs or angiotensin II receptor blockers. Examples of this class of medications include Diovan, Atacand, and Cozar.
Insulin
According to the American Diabetes Association, the goal of treatment in gestational diabetes is to keep blood sugar levels within a normal range for a pregnant woman. Treatment of gestational diabetes includes special meal plans and physical exercise. It may also include the use of insulin injections. The American Diabetes Association states that rapid acting insulins are safe to use during pregnancy. Lispro has been studied extensively. They also concluded that not enough data is available to evaluate the use of long acting insulins in pregnancy although animal studies did not demonstrate birth defects except at exceptionally high doses, according to the "PDR Nurses Drug Handbook."
References
- American Diabetes Association: Insulin Analogs and Pregnancy
- MayoClinic.com: High Blood Pressure in Pregnancy: Healthy Baby, Healthy Mom
- American Heart Association: Chronic Hypertension in Pregnancy
- American Family Physician : The National High Blood Pressure Education Program Report on High Blood Pressure in Pregnancy
- "PDR Nurses Drug Handbook." Roche Pharmaceuticals. 2006
